Tongue tie in newborn?

[atpeace]

Anyone have any experience with tongue tie? DS is a week and a half old now, and I noticed last week he seems to be tongue tied. Nursing is not exactly comfortable, especially on my left side, but seems to be getting better. However, he does make a LOT of noise while nursing, chokes often (fast letdown?), and it takes him a long time to latch on (he roots around my whole chest before he latches on, even though the nipple is right there!). Could these all be from the tongue tie?

I asked my midwife for a referral to a pediatrician (who runs a breastfeeding clinic) to assess this, but that might take a few weeks...what can I do in the mean time? Should we even intervene in the first place? I don't know much about clipping tongue ties, so any experience-sharing would be very appreciated!

[raqi]

DD couldn't get her tongue past her gums, so we decided to get it clipped at almost 4 weeks. I was REALLY sore from her latch (crying while she nursed sore). Not sure about the other symptoms you listed, but the noise could be tongue-tie if it's a clicking-type sound. Going to a lactation consultant helped us make our final decision - is there one you could see sooner than the ped?

[PatioGardener]

Any chance you are heading to Jack Newman's clinic in Toronto? (I don't know of any in Kitchener or Waterloo, which is why I ask ) If so you are in good hands.

A simple tongue-tie (anterior, when the tip of the tongie is 'tied' to the floor of the mouth by a small band of tissue) is easy to clip. The earlier the better if it is causing discomfot or weight gain issues. The worst part is when the doc has to put his finger inthe mouth to open it - babies hate this and usually yell. There is rarely any more than a drop of blood and baby nurses right afterwards. You can see a video of a clipping here: http://www.nbci.ca/index.php?option=...lips&Itemid=13 It is also easy to see the tie in baby's mouth.

There is a good thread here: http://www.mothering.com/discussions...d.php?t=833815 and more info on tongue-tie in the resource sticky at the top of this forum (scroll down.)

Good luck!

[annettemarie]

I'm going to move this to Breastfeeding Challenges.

[Addie]

My DS was tongue tied, we had it clipped at three weeks. He was gaining weight like crazy and didn't have trouble latching, but I was in so much pain - like the PP said, crying and tensing my whole body during each latch. And I had a non-medicated delivery, so I knew something about pain at that point! He's my first, so it took me a while to realize that it shouldn't hurt that much. But I've also heard of tongue tie babies that don't cause pain to the mother. From what I understand, there are basically two circumstances that indicate clipping the frenulum - painful nursing for the mother and failure to gain weight for the baby.

We saw an IBCLC who diagnosed the tongue tie, and then a pediatrician who referred us to a pediatric ear/nose/throat specialist to have it clipped. It was an outpatient procedure that took about thirty seconds, and he didn't even cry. His nursing changed right away, though it took a few weeks for my pain to decrease - I think I just needed time to heal.

The clicking sound that PP mentioned is a classic tongue tie symptom. My DS also choked a lot in the beginning, but I think that had more to do with my letdown.

I'd definitely recommend getting the consult and going from there. Some tongue ties sort of fix themselves as the baby grows, and some need to be addressed. If you're in pain, I'd push to see someone sooner. I've heard that pediatricians can be quick to dismiss tongue tie, especially when the baby is gaining weight, but that wasn't my experience.

Good luck!

[atpeace]

Thanks ladies! Very helpful info and advice. I managed to get an appointment with the breastfeeding-friendly ped for tomorrow afternoon, for a consult, which is super-lucky! The breastfeeding clinic he runs is co-run by nurse practitioners, and staffed by lactation consultants, so I have high hopes. We'll see how it goes...

[nicky85]

If he continues to have problems you might take him to see a pediatric chiropractor. Sometimes a baby's jaw can get pushed out of alignment during birth (even a gentle, natural birth) and that can make it difficult for him to open up his mouth all the way and establish a good latch. Some babies will do kind of a side to side sawing motion with their mouths to try and suck and that can be really uncomfortable for Mom. A few adjustments by a chiropractor should do the trick if that is the problem. Go to www.icpa4kids.org to find a chiropractor.

[aihley]

Originally Posted by Addie

My DS was tongue tied, we had it clipped at three weeks. He was gaining weight like crazy and didn't have trouble latching, but I was in so much pain - like the PP said, crying and tensing my whole body during each latch. And I had a non-medicated delivery, so I knew something about pain at that point! He's my first, so it took me a while to realize that it shouldn't hurt that much. But I've also heard of tongue tie babies that don't cause pain to the mother. From what I understand, there are basically two circumstances that indicate clipping the frenulum - painful nursing for the mother and failure to gain weight for the baby.

We saw an IBCLC who diagnosed the tongue tie, and then a pediatrician who referred us to a pediatric ear/nose/throat specialist to have it clipped. It was an outpatient procedure that took about thirty seconds, and he didn't even cry. His nursing changed right away, though it took a few weeks for my pain to decrease - I think I just needed time to heal.

The clicking sound that PP mentioned is a classic tongue tie symptom. My DS also choked a lot in the beginning, but I think that had more to do with my letdown.

I'd definitely recommend getting the consult and going from there. Some tongue ties sort of fix themselves as the baby grows, and some need to be addressed. If you're in pain, I'd push to see someone sooner. I've heard that pediatricians can be quick to dismiss tongue tie, especially when the baby is gaining weight, but that wasn't my experience.

Good luck!

DS had a tongue-tie that was diagnosed in the hospital but it took nearly 6 months to find someone who'd correct it. I couldn't find ANYONE who would just clip it with blunt medical scissors - DS had to be put under general and they used a cauterizing laser to cut it. It seemed way more complicated than it should've been, especially after watching that video. His tongue-tie was the kind that hurt me - I know there are different degrees of tie as well as different positions. An anterior tie is at the tip of the tongue and creates the classic heart shaped tip. The posterior tie is more difficult to diagnose for most doctors and ties the middle of the tongue down. I found an old thread here that has some more information: http://www.mothering.com/discussions....php?t=1077281

Most tongue-ties should be corrected. We did it primarily to relieve my pain but also to prevent the ordeal of needing speech therapy to correct any speech difficulties that can occur. Try asking for doctor recommendations for your area to find someone who'll simply clip. The only think I could think of for you to do until you get a referral is to just research as much as you can about it. You can try and pump through your letdown if it's overactive. During the first month or so, I had to pump and feed my little guy with an eyedropper for nearly three days to get some relief from the pain. Hope you guys can get it fixed soon!

[atpeace]

aihley - wow, your clipping sounds much more intense than what we had done! I didn't know they do general anesthesia for tongue clippings! Perhaps yours was more complicated?

We got a very quick appointment with a lactation consultant/pediatrician, and they clipped it very simply with a surgical razor-blade type thing. The whole procedure took literally less than 5 seconds, with the lactation consultant holding him and opening his mouth, and the ped. doing a simple snip, which took a single second. I was much more scared about it than I needed to be. DS barely cried (only when they were prying his mouth open, not during the actual cutting or after), and there was no blood. He was totally fine afterwards and his tongue is so much more mobile now! No soreness anymore, but we're still struggling with the oversupply and overactive let-down...

[PatioGardener]

great to hear the clipping went well! hope the over supply settles soon. mine took about 10 weeks of actively working on it. i think my body thought i had triplets!

nak

[Sunshinesmiles22]

Good to hear others experiences. I think my 3 year old had it, but didn't know it then. It seems to have worked itself out. My only clues were the clicking noise (didn't know what it was then!), and a long nursing. I have an overabundance of milk, so that was never the issue. It just felt like I couldn't get a break!

Now with number 2 (3 1/2 months), she's actually been "diagnosed" with a real minor tongue tie. The doctor dismissed it like a pp said, because of good weight gain. I'm wondering now whether we should go ahead and get this done.

I'm hesitant because of high deductible insurance, so it would be out of pocket, and wondering if it's worth it. Mine seems to be hungry so much, but not sure if that's because she's not efficient in getting milk out and gets franctic, or from too much foremilk, or what.

Does it seem worth it?

Also, who actually does it? I was referred to my dentist who does it with a laser, but can pediatricians do it?

[atpeace]

Hmmm, I've never heard of a laser being used, and it seems like overkill, from my first impression. A tiny surgical blade works perfectly well, and seriously, it takes a second, so I don't think a laser would be worth it (and probably much more expensive too!)...it probably takes much longer to set up and position the baby and hold him/her down while using a laser. But again, I am totally ignorant about this method, so maybe I'm just blabbering nonsense.

How much would it cost you? Did they give you a quote? I have no idea about costs, since in Ontario, health care is covered by the government, so we don't pay or have to deal with insurance. I think if you are worried about the cost, and if it's astronomical, maybe wait on getting it done, and see if it needs to be done when she gets older? A minor one might not affect her in any way and may not need to be done. Some may affect speech, but I guess you won't know until she starts talking.

In our case, the pediatrician did it, with the lactation consultant assisting. Our midwives used to do them, but some sort of law got changed and they now are required to refer to the pediatrician. I think some family doctors can do them too. It probably depends on your area and who is available.

Good luck!

[Casha'sMommy]

DD (4yo) is fairly tongue tied and nursed like a champ until she weaned herself at 2yo
I noticed the possibility of a poor latch during her first days but that quickly rectified itself. It just took a little work on my part to get her latched really well. After just a few days she was having no issues.

Also, dh, bil, mil, dh uncle and dh grandmother are all tongue tied. mil nursed all of her children well into their toddler years and none had their tongue clipped.

hth and gl!

[aihley]

Originally Posted by atpeace

Hmmm, I've never heard of a laser being used, and it seems like overkill, from my first impression. A tiny surgical blade works perfectly well, and seriously, it takes a second, so I don't think a laser would be worth it (and probably much more expensive too!)...it probably takes much longer to set up and position the baby and hold him/her down while using a laser. But again, I am totally ignorant about this method, so maybe I'm just blabbering nonsense.

How much would it cost you? Did they give you a quote? I have no idea about costs, since in Ontario, health care is covered by the government, so we don't pay or have to deal with insurance. I think if you are worried about the cost, and if it's astronomical, maybe wait on getting it done, and see if it needs to be done when she gets older? A minor one might not affect her in any way and may not need to be done. Some may affect speech, but I guess you won't know until she starts talking.

In our case, the pediatrician did it, with the lactation consultant assisting. Our midwives used to do them, but some sort of law got changed and they now are required to refer to the pediatrician. I think some family doctors can do them too. It probably depends on your area and who is available.

Good luck!

Yeah, it's overkill, but when your insurance only covers certain dr.s and those dr.s all want to send your kid to an ENT for the procedure & you finally find one willing to do the procedure (a 5-month process), then you take what you can get. They don't hold the baby down when using the cauterizing laser (the same they use in surgery & many dentist offices), they put your baby under general. I hated it and would've taken the in-office snip with blunted surgical scissors any day. But that just was not available to us. And we wonder why our health costs are so high! Using a specialized laser and $500 in anesthetic alone plus the time and energy of several nurses for over an hour start-to-finish when the same thing could be accomplished in a matter of minutes with scissors. Not to mention the time of the referring doctor and the two pre-op appointments.

But heaven forbid we get socialized medicine here! We might have to wait for a procedure! So what does it take to become a Canadian citizen?

ETA: It's not a big deal if mom isn't howling in pain for 6 months at every latch and baby is gaining well. Then you can just wait and see if it affects speech. Don't stress about it unless it's causing a problem.

And my little guy's wasn't more complicated at all. The doctors were the one's who wanted to do it that way and insisted they'd NEVER heard of the simple in-office clip.

[Erinz]

I watched the doctor snip my first son's tongue tie at 5 weeks (after 5 weeks of intense pain and my crying at every nursing). I've now come to understand my over supply and continued engorgement and crazy letdown could have all been related. My son also gained weight like nuts.

eta: Upon that first nursing post-clip I noticed a HUGE difference. It took some time for the massive cracks on my nipples to heal (I can still see the scars several years later). The pain was so immediately reduced that I cried in frustration at not having it fixed sooner. My memories of those first few weeks of new mommyhood are clouded in pain. Terrible.

For my second son I checked right away and he was also tongue tied so my husband and I got out the sterile surgical scissors we had purchased just in case and did a little snip ourselves (he was born at home). We were very conservative so ended up having to make two little snips but my son didn't even notice. What a different newborn experience it was to not be in pain!

[mom2sander]

You may also want to contact your local La Leche League leader for a list of area doctors who are available to assess and clip tongue tie. I am a leader in Westchester County, NY, and have a list of doctors in the area who are all breastfeeding friendly, and will do the procedure in office, that day. I wish you the best of luck. . . I went through this with my little one.

[hezasan]

My ds had a posterior tongue tie, you couldn't really see it but if you sweep your finger under his tongue, there is a band of resistance in the middle. Wouldn't have been an issue at this point, except for the PAIN I experienced for three months and the non-stop feeding as well. Ours was a simple office procedure thankfully, he cried about as much as he would for a shot and then nursed afterward.
And I meaned nursed, for REAL! The first time I heard swallowing, and the whole suck-pause-swallow sequence that Dr. Newman describes. I didn't even know we were missing that until I saw it for real, immediately after the tongue-tie clip.
As others have mentioned, the pain takes a little while to resolve (a few weeks for us) if you've been living with it for a while. But the difference in nursing was definitely worth it for us!
BTW we went through several lactation consultants/doctors before we found one that even knew anything about posterior tongue tie, so if you (meaning anyone reading this) don't feel your issues are resolved keep looking!

[2xy]

DS1 was tongue-tied. My mother noticed it right away, before anybody else did. The doc said that as long as nursing wasn't problematic, to leave it alone. Nursing was never a problem, nor was speech. But when he was 13 he had his tonsils removed and we elected to have the frenulum snipped while he was under. It would frequently get caught between his two bottom teeth and rip or just get sore. He's happy to have had it done. Apparently, tongue-tie runs in his dad's side of the family. So much that his father thought tongue-clipping was a routine part of infancy!

[saoirse2007]

dd was too - Jack Newman snipped her in my midwife office.

I killed me- I cried

but no more bleeding cracked nipples- and no more dreading to nurse her

[Strong&True's Mom]

I didn't know how easy we had it

My heart breaks for some of the stories I'm reading. My DS was diagnosed by our midwife at the 24hour check-up. My pediatrician had dismissed it and said we'll wait and see if speech delays develop even though I was in great pain nursing. (As my 2nd child, I knew it shouldn't be painful).

The lactation consultant I called directed me to a pediatric dentist. So even before I saw the lactation consultant I was able to get in to see the dentist when he was just 3 days old. It was so easy. The cauterizing tool didn't seem to hurt at all. He didn't need a stitch or anything. There was barely a drop of blood and I nursed him immediately for comfort. I think he was more mad at the fingers in his mouth than the snip.

I couldn't have imagined going weeks with that painful breastfeeding. I was already considering pumping because it hurt so badly. I could relate to the other post about tears while feeding. It did end up costing me around $300 because the insurance didn't pay. It was totally worth it!

My pediatrician was surprised at the week visit when I said I had already had it done. She seemed open to learning about it. I hope more doctors will. My midwife said it used to be standard practice at birth for a midwife to run her thumb nail under every newborn's tongue to fix any tie.

It does seem to run in families. My brother had his fixed after college by a dentist or an oral surgeon. It always bothered him though no speech delay and my mom didn't nurse us.

It was such a simple proceedure that my heart aches for all the mommies who had trouble.